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Comment by thenerdhead | Hacker News Reader

This is a big deal. Doctors are constantly telling patients they are “deconditioning” and encouraging exercise as a result. There is a large controversy of exercise clinical trials for that reason. Experiencing this first hand, I am in very good shape and have excellent stamina. On certain days when my mitochondria are hijacked(it is cyclical for my long Covid), you couldn’t tell the difference of me(young 30 year old gym goer) and an 80 year old man from walking up the stairs. The virus is persisting likely in our gut and hijacking our powerhouse of the cell! Many studies are showing this is likely the case.

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Covid can indeed persist in the gut, but it just causes gi symptoms, and the virus is undetectable after 10 months

https://www.cell.com/med/fulltext/S2666-6340(22)00167-2

So, I suspect your symptoms may be due to another mechanism.

What is your resting heart rate, and how is your sleep?

My RHR baseline(average) is 51. HRV baseline(average) is 95. I sleep very well & consistently but wake up feeling wired & tired (common in chronic fatigue I suppose). My cardio fitness averages to 52.9 which is a measurement of my VO2 max.

I have read thousands of covid / long covid papers. I think you would be surprised at what symptoms persistent virus in the gut lead to:

https://www.cell.com/cell/fulltext/S0092-8674(23)01034-6

The books "I contain multitudes" and "Gut" are excellent recent titles helping bring light to the power of the gut. I personally think some other organs may be involved too and even the vagus nerve. But none-the-less covid is hijacking mitochondria:

https://pubmed.ncbi.nlm.nih.gov/37556555/

Did you look carefully at that serotonin paper? It's pretty underwhelming. Check out the comments on s4me if you haven't already:

https://www.s4me.info/threads/serotonin-reduction-in-post-ac...

There is a lot of crap science published, and that serotonin paper is pretty poor.

Anyway, it's up to you what science you want to pursue. I managed to recover from ME/CFS myself by looking deeply into the science, so I'd recommend looking further. Stress seems to be one of the major issues. Anyway, from what you say it sounds like your symptoms are pretty mild (correct me if I'm wrong here).

Thanks for sharing your opinion. I don't share it, but appreciate you taking the time.

No, I have no opinions on that serotonin paper. I was just referring to the facts, which are that other papers haven't replicated its findings and there are a lot of factors that affect serotonin that they haven't taken into account. If you're interested, take a look. If not, no worries.

Look, I'm more than willing to hear your opinion but I'm not going to dig for yours in a forum post. I took one look and immediately sent you that comment because those are opinions I do not even remotely share besides the last post of someone who linked a detailed newsletter talking about why this work is important.

There is also a great re-cap of this work here:

https://youtu.be/278vwGkFXRM?t=13406

Fair enough, its always better to analyze it yourself and check the validity of any particular research or criticism of such research. Opinions in science arent really useful unless they are weakly held and based on the evidence. If you have any response to the main points i posted above feel free to post. As i said i have pretty much zero opinions on this, and have only looked at it very briefly.

PS downvoting good faith discussion is bad form.

What are you saying here? That this entire paper and subject area is an "opinion"?

I still do not know what your main points are here. This study isn't going to be replicated yet because it is considered a "breakthrough" and only two months published. It is going to have limitations because all studies do and authors disclose what they think are their limitations.

Also I haven't downvoted anything for what it is worth.

Another study has already been done and failed to replicate this from what I can see.

Okay link it?

It was in the s4me discussion. I think the more interesting question is why you put so much stock in a study you admit is exploratory, which you havent checked for validity.

Two studies that explore metabolic pathways in different ways. That doesn't mean they "failed to replicate". This happens all the time in science, especially EBV research. For example they failed to find EBV reactivation in long covid in one study, but then also found that it is a smoking gun in others. Aside that, what is your gripe with the Penn study?

Okay, you believe you have persistent virus impacting your systemic health, possibly by allowing other opportunistic infection, then you would take an antiviral.

Let us know what happens after that?

Or this:

https://www.medscape.com/viewarticle/monoclonal-antibodies-n...

I’ve heard the “undetectable” bit with Epstein-Barr.

Suffice to say, it’s pretty uncompelling, as far as contrarian evidence for viral involvement is concerned =]

Your comment is somewhat unclear, and I'm not sure what part "contrarian" is referring to. We just go on the evidence we have, and so far there isn't any evidence (as far as I'm aware) that covid survives longer than a year in the gut, or that it causes non-GI symptoms in the gut.

EBV is very detectable when it reactivates. When it is dormant it doesn't cause symptoms, as far as we know. Even when it reactivates it's unclear if it causes symptoms (that happens in astronauts and students taking exams, and they don't report ME/CFS symptoms).

> EBV is very detectable when it reactivates.

Yes, but to do this, first:

- find a doctor that “believes” post EBV infection problems are even real

- wait 2-5 weeks for appointment and prescription for blood work

- get laughed at when it shows Undetected again

- prepare for next bout of illness some weeks or months later

This is the failure mode for many EBV patients, especially those dealing with other opportunistic infections at the same time.

I'm someone who has suffered from post-viral ME/CFS, so I know how devastating it is. However, there isn't any evidence that EBV reactivation causes symptoms. (Initial mono infection is different).

- multiple studies in ME/CFS patients, even ones with EBV reactivation, show that antivirals aren't helpful. - students studying for exams and astronauts have high EBV titers (signifying reactivation), but they don't have any kind of ME/CFS symptoms.

EBV reactivation is just a symptom, caused by stress. It doesn't seem to be central to the illness itself.

Now we need to expand on what “stress” can cover, for the very diverse set of humans on this planet (it’s a long list - even just being too warm or cold for too long!).

Also, I mentioned pretty specifically why it’s pretty difficult, even in retrospective studies, to link the symptom with the Active status in blood work - were you uncompelled by this, disagree for some reason?

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